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Assoc Prof Mark Hughes, Southern Cross University: Ageing in LGBTI communities : negotiating sexual identity in health and aged care


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Assoc Prof Mark Hughes, Coordinator, BSocSc, BSocWelf, MSW (Prof Qual) ,School of Arts and Social Sciences, Southern Cross University delivered this presentation at the 2013 LGBTI Aged Care Forum. The …

Assoc Prof Mark Hughes, Coordinator, BSocSc, BSocWelf, MSW (Prof Qual) ,School of Arts and Social Sciences, Southern Cross University delivered this presentation at the 2013 LGBTI Aged Care Forum. The two day event offers a platform for discussion on national policy issues, mental and physical health and implementing sensitive quality care and service delivery.

The forum brings together LGBTI community leaders plus senior researchers on LGBTI issues in the aged and health care sectors, to share perspectives on good practice insights for real needs as well as strategies to build community and sector capacity. For more information about the event, please visit the conference website:

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  • 1. Negotiating sexual identity in health & aged care Mark Hughes Associate Professor School of Arts & Social Sciences Southern Cross University
  • 2. Research background      Focus groups with SWs & older gay men on talking about sexual identity in aged care Narrative research on older lesbians & gay men accessing health & aged care in Blue Mts Analysis of QAHC survey on LGBT people’s expectations of growing older Analysis of SCU/ACON project on end of life care for LGBTI people Current project (with Evergreen Life Care) surveying LGBTI people aged 50+ on wellbeing
  • 3. What is sexual identity?     The labels that people ascribe to themselves or others that relate to sexuality Most commonly focuses on: gender of people we are attracted to Because heterosexuality is normalised, by default ‘sexual identity’ refers to non-hetero identities i.e. lesbian, gay, bisexual (LGB) identities Most recognise that sexuality/sexual identity is both biologically and socially constructed
  • 4. Dimensions of sexual identity Sexual behaviour Sexual attraction (orientation) Sexual identity Sense of self as emerging across lifespan Community/group affiliation Social context, e.g. - normative gender relations - ethnicity & culture - socio-economic circumstances - cohort experiences - policy/service environment
  • 5. Discrimination based on sexual identity    Homophobia: the fear, hatred or mistrust of LGB people often expressed in overt displays of discrimination Heterosexism: the privileging of heterosexuality over other identities – creates obstacles for LGB people in living their daily lives – intersects with gender identity to impact on trans & intersex (TI) people Heteronormativity: the (often implicit) assumption that heterosexuality is the norm and is universal – can render non-heterosexual people invisible
  • 6. Critical issues for LGBTI older people       Growing up in a time when homosexuality was illegal & highly stigmatised Actual current or prior experience of discrimination Expectation of discrimination when accessing mainstream services: impact on help seeking Ageism within LGBTI communities, esp. in commercial ‘scene’ Concerns (esp. gay men) about isolation and loneliness in later life Desire for LGBTI specific services or providers
  • 7. Critical issues cont.      Desire for mainstream services to be more LGBTI friendly Negotiating privacy in identity disclosure Need for ‘cultural competency’ with LGBTI communities Need for recognition of complexity of sexual identity & community affiliation Breaking down ‘heteronormativity’ – assumption that all people are heterosexual
  • 8. Some ideas for negotiating sexual identity  Be open to & recognise complexity of sexual identity       Sexual behaviour Sexual attraction Sense of self as it emerges across the lifespan Community/group affiliation Develop LGBTI responsiveness within your teams – training is available (e.g. via QAHC & ACON) Build relationships with LGBTI communities, organisations & groups
  • 9. Some ideas for negotiating sexual identity cont.     Get involved in advocacy campaigns Recruit staff/volunteers who are LGBTI or who have expertise in working with these communities Develop & display prominently LGBTI positive messages Back this up with responsive & non-discriminatory service delivery    Appropriate interviewing/questioning Attending to cues Appropriate forms, information sheets, etc
  • 10. Some of my publications on LGBTI ageing Hughes, M. (2003) Talking about sexual identity with older men. Australian Social Work, 56(3), 258-266. Hughes, M. (2004) Privacy, sexual identity and aged care. Australian Journal of Social Issues, 39(4), 381-392. Hughes, M. (2004) Privacy in aged care. Australasian Journal on Ageing, 23(3), 110-114. Hughes, M. (2006) Queer ageing. Gay and Lesbian Issues and Psychology Review, 2(2), 54-59. Hughes, M. (2007) Older lesbians and gays accessing health and aged care services. Australian Social Work, 60(2), 197-209. Hughes, M. (2008) Information placed in trust: social workers and older gay men on talking about sexual identity. Geriaction, 26(1), 15-20. Hughes, M. (2008) Imagined futures and communities: older lesbian and gay people’s narratives on health and aged care. Journal of Gay and Lesbian Social Services, 20(1/2), 167-186. Hughes, M. (2009) Lesbian and gay people’s concerns about ageing and accessing services. Australian Social Work, 62(2), 186-201. Hughes, M. (2010) Expectations of later life support among lesbian and gay Queenslanders. Australasian Journal on Ageing. 29(4), 161-166. Hughes, M. & Heycox, K. (2010) Chapter 9: Sexuality and intimacy. In Older People, Ageing and Social Work: Knowledge for Practice. Sydney: Allen & Unwin. Hughes, M. & Kentlyn S. (2011) Older LGBT people’s care networks and communities of practice: a brief note. International Social Work. 54(3), 436-444. Cartwright, C., Hughes, M. & Lienert, T. (2012) End-of-life care for gay, lesbian, bisexual and transgender people: An exploratory study. Culture, Health and Sexuality, 14(5), 537-548. Hughes, M. (2013) Sexuality and social work. Chapter 8 in M. Connolly & L. Harms (Eds.) Social Work: Contexts and Practices, 3rd Edn. South Melbourne: Oxford University Press.